40 Years of HIV: It’s time to end the HIV epidemic

June 5 is a landmark anniversary, one of great joy and pride mixed with sorrow and grief. On this day 40 years ago, the CDC reported perplexing cases of rare diseases among five healthy gay men in Los Angeles. None of us at the time had an inkling of what was to follow. The first several years of the HIV epidemic were filled with fear and marked by stigma. Hope was hard to find as more and more people succumbed to what was then a death sentence. However, there were glimmers of hope as advocates and communities demanded that government and society listen to those at greatest risk and those that were dying and take action. It may be hard for many to imagine such a time, but for the people who lived through it, those days and the millions who did not survive live on in our memories and the stories we tell.

Today, the world, both in its response to HIV and health more generally, is different and better. Information, testing, treatment, comprehensive programs, and a commitment to ending HIV stigma and inequities have made HIV a chronic but manageable disease, particularly for those who can get services. There is much work still to do, but we have the tools we need, and new ones are on the way.

Since the earliest days, JSI has been there, at first simply by supporting staff living with HIV when denial and disdain were the norm. As opportunities arose, we implemented programs in solidarity with and response to communities in the U.S. and around the world’s needs, tackling inequalities and bringing new science and learning to our every effort. On this anniversary, we recommit to ending HIV around the globe and honoring the passion and memory of those who are no longer with us.

1981

1981

CDC publishes the Morbidity and Mortality Weekly Report describing five cases of a rare lung infection in young, previously healthy, gay men in LA. This marks the official reporting of what will become the AIDS epidemic. The New York Times publishes its first news story on AIDS.

1982

1982

CDC establishes the term ‘acquired immune deficiency syndrome.’ The first AIDS cases in Africa are reported in Uganda and a number of European countries. 

1983

WHO holds its first meeting to assess the global AIDS situation, and begins international surveillance.

1984

A blood test is created to screen for the virus, with the hope that a vaccine could be developed in two years.  There are an estimated 7,699 AIDS cases and 3,665 AIDS deaths in the U.S. 762 cases are reported in Europe.

1985

1985

Ryan White, an Indiana teenager who contracted AIDS through contaminated blood products used to treat his hemophilia, is banned from school. Every region in the world has at least one case of AIDS, with 20,303 cases in total.

1986

1986

In partnership with HRSA, the Robert Wood Johnson Foundation creates the AIDS Health Service Program, a precursor to the Ryan White CARE Act. 

1987

1987

The FDA approves AZT, the first antiretroviral drug as a treatment for HIV. WHO reports 71,751 cases of HIV; 47,022 of which are in the U.S. An estimated 5–10 million people are now living with HIV worldwide. 

1986

1986

The virus causing AIDS is officially called the human immunodeficiency virus (HIV). CDC reports that AIDS cases are disproportionately affecting African Americans and Latinos, particularly children.

1988

JSI is awarded its first HIV project, Training for Healthcare Providers on the Psychosocial Aspects of AIDS, funded by the National Institute of Mental Health. JSI evaluates the AIDS Regional Education & Training Center.

1988

First World AIDS day is hosted on December 1st. HRSA awards HIV planning grants to 11 states and 10 cities to create a plan for HIV systems of care, which lay the groundwork for the Ryan White CARE Act.

1989

1989

JSI is selected to lead its first HRSA-funded HIV project, Assessing the impact of HIV on Community Health Centers.

1989

1989

WHO estimates up to 400,000 cases of HIV worldwide.  CDC reports that cases in the U.S. reached 100,000.

1990

1990

Ryan White, the Indiana teen who becomes an international spokesperson against HIV stigma and discrimination, dies of AIDS-related illness at the age 18. Later in the year, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 passes, which provides $220.5 million in federal funds in HIV community-based care and treatment services in its first year.  Over 307,000 HIV cases in the U.S. are officially reported, with the actual number estimated to be closer to a million. 

1991

JSI’s first state HIV work in Massachusetts, Technical Assistance & Training Support for the HIV/AIDS Bureau Massachusetts DPH, launches. JSI launches its first HIV and substance use project, Residual Impediments to Treatment of HIV Infection & Substance Abuse Problems.

1991

JSI launches its first international project – HIV/AIDS AIDS Control and Prevention Project (AIDSCAP).

1992

AIDS-related complications become the number one cause of death for U.S. men ages 25 to 44.

1992

JSI implements HIV/AIDS Training for Mental Health Providers with Harvard School of Medicine & Boston University School of Medicine. 

1993

JSI is selected to evaluate the HIV Service Demonstration Program. JSI implements the first Ryan White C.A.R.E. Act Technical Assistance contract.

1993

1993

U.S. Congress votes to retain the ban on entry into the country for people with HIV.  CDC expands the case definition of AIDS, declaring people with CD4 counts below 200 as having AIDS.  An estimated 2.5 million people are living with HIV worldwide.

1994

1994

JSI implements Malawi Support to Family Health and AIDS Project through USAID.

1995

1995

JSI implements Family Health and AIDS project in West and Central Africa through USAID.

1994

JSI Implements Self Assessment Tools for Ryan White HIV Planning Councils and HIV Care Consortia. JSI implements Five Year Needs Assessment and Planning Report on the HIV/AIDS Epidemic in Massachusetts.

1994

1994

The USA Public Health Service recommends the use of AZT to prevent the mother-to-child transmission of HIV.  The FDA approves the oral HIV test, the first non-blood HIV test. AIDS becomes the leading cause of death for all Americans ages 25–44.

1995

JSI implements Studies to Estimate the Prevalence of HIV in Selected Massachusetts Populations.

1995

There are an estimated 4.7 million new HIV infections; 2.5 million in Southeast Asia and 1.9 million in sub-Saharan Africa.

1996

1996

FDA approves protease inhibitors and nevirapine; introduction of highly active antiretroviral therapy. An estimated 23 million people are living with HIV worldwide.

1997

JSI implements Women of Color AIDS Council, a clinical trial for vaccine GP160 study in MA, including high enrollment of people of color and women.

1997

1997

UNAIDS estimates that 30 million people have HIV, with 16,000 new infections a day. 

1998

JSI evaluates the Massachusetts Non-Names-Based System of HIV Reporting project, as a means of protecting privacy when positive HIV tests become reportable to the health department. JSI implements National Non-Occupational HIV Postexposure Prophylaxis Registry.

1998

JSI implements HIV/AIDS Technical Assistance to Vietnam National Youth Union.

1999

JSI’s implements its first HIV needs assessment and Comprehensive HIV Plan for Santa Clara County with over 1,200 individuals, including men who have sex with men, people who inject drugs, and women of color and youth at risk for HIV.

1999

1999

JSI implements the Dominican Republic Global Orphans Project through USAID to study the effects of HIV on children ages 0 to 14 in collaboration with the Presidential Commission on AIDS and the MOH National AIDS Program.

1999

JSI evaluates Integrated Substance Abuse and HIV/AIDS Prevention in Minority Communities. Findings from the research show that programs changed perceptions of risk for substance use and high-risk sexual behaviors as well as reducing drug use.

1999

1999

WHO announces that AIDS is the fourth biggest cause of death worldwide and the number one cause of death in Africa. 33 million people are living with HIV worldwide, and 14 million have died of AIDS-related complications.

2000

The New Hampshire STD/HIV Program and the HIV Community Planning Group contracts JSI to implement a comprehensive needs assessment of the care and prevention needs of persons living with HIV in New Hampshire, as well as the prevention needs of persons of color at risk.

2000

JSI publishes The Contraceptive Forecasting Handbook for Family Planning and HIV/AIDS Prevention Programs.

2000

2000

The UN adopts the Millenium Development Goals, which include a specific goal to reverse the spread of HIV, malaria, and tuberculosis.

2001

JSI & World Education Center for HIV is established. The Rhode Island Department of Health, Office of HIV/AIDS, contracts JSI to evaluate its CDC-funded HIV prevention projects.

2001

JSI implements Logistics Management Services for HIV/AIDS Prevention and Care Project, Kenya.

2001

JSI’s Uganda AIDS/HIV Integrated Model District Programme (AIM) launches. AIM catalyzed the development of model strategies and initiatives in the HIV response in 16 of Uganda’s districts, comprising roughly one-third of the country’s 25 million people.

2002

2002

JSI joins partners for the HRSA Special Projects of National Significance (SPNS)-funded Improving Medication Adherence, A Randomized Control Trial Comparing Clinic-Based Care to Clinic-Based Care Enhanced by Community/Home Care. This study evaluated the ability of 4–6 weeks of home nurse visits to improve adherence to HIV medications.

2002

2002

JSI manages the Mother-to-Child Transmission Plus Data Management Center with Columbia University, handling data for more than 9,300 patients in 18 clinical facilities, across 8 countries in Africa and Asia.

2002

The Massachusetts Department of Public Health HIV/AIDS Bureau selects JSI to generate a continuous quality improvement plan, including clinical chart reviews and annual data reports, for use in publicly funded HIV clinics.

2002

JSI implements Global Fund Procurement Supply Management Assessment in Haiti.

2002

2002

Global Fund to Fight AIDS, Tuberculosis, and Malaria, a partnership between governments, civil society organizations, the private sector, and affected communities is established.  

2003

The Denver HIV Resources Planning Council contracts JSI to identify service needs, and barriers and available resources for persons living with HIV in the Denver Eligible Metropolitan Area.

2003

2003

JSI contributes to the development of the President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR is a $15 billion program to prevent and treat AIDS in countries with a high burden of infection.

2003

JSI and World Education develop and implement an HIV workplace policy across all offices to convey information on  HIV prevention, access to antiretroviral therapy (ART), and stigma and discrimination.

2003

2003

WHO announces it’s “3 by 5” initiative, to bring HIV treatment to 3 million people by 2005.

2004

2004

CDC funds JSI to implement the HIV Capacity Building Assistance project to help capacity building organizations and health departments to implement, improve, and evaluate HIV prevention interventions in Latino communities in the Midwest. The project expanded nationally in 2009.

2004

2004

In collaboration with The Elizabeth Glaser Pediatric AIDS Foundation, JSI implements The “Help Expand Antiretroviral Therapy to Children and Families” Project to provide care and treatment services to children and adults with HIV in Côte d’Ivoire, Mozambique, South Africa, Tanzania, and Zambia. JSI provided technical assistance through site monitoring at designated HIV and AIDS clinics in the five host countries.

2004

JSI implements the HIV Prevention: Rapid Interventions to Decrease Unsafe Injections project across Ethiopia, Mozambique, Nigeria, and Uganda to develop national policies and action plans and strengthen forecasting, procurement, and distribution of safe injection devices.

2004

The JSI-implemented Central Asian Program on AIDS Control in Vulnerable Populations built technical capacity to launch large-scale and urgent responses to the spread of HIV in Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan.

2004

JSI is awarded the Zambia Support to the HIV/AIDS Response Program, which worked with employers and other workplace programs to establish and strengthen HIV prevention, treatment, and support services for employees, families, and the community at large to reduce employee absenteeism.

2005

2005

JSI collaborates with HRSA’s HIV/AIDS Bureau to help grantees streamline and improve data gathering and reporting capacity through the Ryan White Data TA Center.

2005

2005

USAID Supply Chain Management Systems project launches. Between 2005 and 2016, SCMS procured and distributed essential health products for people living with, and affected by HIV. SCMS supported 9.5 million patients who received ART. During SCMS, the cost of drugs to treat a single HIV patient dropped from about $10,000 per year to $110 per year. Among its other accomplishments, SCMS achieved 84% on-time delivery of core products, and more than $149 million in savings by switching from branded to generic antiretrovirals.

2006

2006

JSI begins work on the Leadership Campaign on AIDS, which becomes AIDS.gov, then HIV.gov. HIV.gov expands visibility of timely and relevant federal HIV and viral hepatitis policies, programs, and resources to the American public; increases use of new media tools by the government, minority, and other community partners to extend the reach of programs to communities at greatest risk; and increases knowledge about and access to services for people most at-risk for or living with HIV and/or viral hepatitis.

2006

2006

WHO reports that the number of people receiving HIV ART in sub-Saharan African has surpassed 1 million a 10-fold increase in treatment access in the region since December 2003.

2007

2007

JSI implements Enhancing Access to Quality HIV Care for Women of Color, a HRSA SPNS, to understand the context and causes of why women may not access, engage, or remain in effective clinical care, and identify best practices for enhancing access to high-quality HIV care for women of color.

2007

WHO and UNAIDS issues new guidance recommending provider-initiated testing in health care settings to widen knowledge of HIV status and greatly increase access to reatment and prevention.

2008

The U.S. Health and Human Services Office of HIV/AIDS Policy selects JSI to evaluate the Minority AIDS Initiative Secretary’s Fund. Our findings were used to guide the management of Minority AIDS Initiative Secretary’s Fund programs during 2011.

2008

2008

In an effort to broaden the pool of nongovernmental organizations that provide innovative, high-quality HIV services, the PEPFAR-funded USAID New Partners Initiative (NPI) is established and implemented by JSI. NPI funded and provided technical assistance to organizations new to USAID support to build their capacity to comply with USAID requirements.

2008

JSI implements USAID’s global HIV leadership project  AIDSTAR-One across 36 countries. AIDSTAR-One synthesized and disseminated scientific research and models of successful program implementation in all areas of HIV, and provided targeted technical assistance to build effective and sustainable programs.

2008

2008

JSI and its partner, Initiatives Inc., implement the Technical Assistance to the New Partners Initiative (TA-NPI), funded by the U.S. Centers for Disease Control and Prevention (CDC). TA-NPI’s goal was to build the quality of program implementation and strengthen the capacity of indigenous organizations receiving Rounds 2 and 3 funding through NPI. The project worked with 11 established local nongovernmental organizations in sub-Saharan Africa and Haiti.

2008

2008

President Bush authorizes PEPFAR for an additional 5 years for up to $48 billion. 

2009

2009

JSI is funded by the CDC to provide capacity-building services to help community-based organizations across the country plan, implement, and sustain a high-impact approach to HIV prevention.

2009

President Obama lifts the HIV travel and immigration ban by removing final regulatory barriers to entry.  UNAIDS reports a 17% decline in new HIV infections in the past 10 years. East Asia, however, has seen a dramatic 25% increase in infections over the same period.

2010

JSI implements Support to the HIV/AIDS Response in Zambia II. The project reached 11,490 people living with HIV with a minimum package of prevention interventions between 2010 and 2015.

2010

Obama administration releases the first comprehensive National HIV/AIDS Strategy for the United States.

2011

JSI evaluates the 12 Cities Project, which supports comprehensive HIV planning and cross-agency response across 12 U.S. jurisdictions with the greatest cumulative number of AIDS cases.

2011

Studies report that early ART can prevent HIV transmission.

2012

2012

JSI studies the impact of Section 1115 Medicaid waivers on the Ryan White HIV/AIDS Program, including clients and service providers.

2012

2012

JSI launches Advancing Partners and Communities in 40 countries to support programs that seek to improve the overall health of communities.

2012

2012

The FDA approves the use of Truvada for pre-exposure prophylaxis (PrEP) as well as the first at-home HIV test that will let users learn their HIV status right away.

2013

JSI launches the Access, Care, and Engagement TA Center to help Ryan White HIV/AIDS Program to help grantees and providers enroll diverse clients, especially people of color, in health coverage under the Affordable Care Act. 

2013

2013

UNAIDS estimates that worldwide, 2.3 million people were newly infected with HIV during the year, and 1.6 million people died of AIDS-related complications. Approximately 35.3 million people around the world are now living with HIV, including more than 1.2 million Americans.

2013

2013

JSI provides technical assistance on the development of the CDC Get Yourself Tested Social Marketing Campaign for HIV/STI prevention in high schools.

2014

2014

Strengthening High Impact Interventions for an AIDS-Free Generation (AIDSFree) launches. Through AIDSFree, 1,830,000 people were tested for HIV, identifying nearly 50,000 people as HIV positive. Additionally, 43,000 people were enrolled on ART, and 950,000 men had voluntary male medical circumcision procedures.

2014

In Santa Clara County, CA, JSI develops I’m on It! campaign focused on getting Latino and African American men who have sex with men and African American women tested.

2014

2014

JSI launches the Community Health and Social Welfare Systems Strengthening Program, which helped the government of Tanzania create its first national system for managing HIV care.

2014

JSI implements the Infectious Disease Capacity Building contract for the Massachusetts DPH to provide technical assistance and support quality improvement and policy analyses across infectious diseases and now includes the Technical Assistance for Service Integration project.

2014

2014

UNAIDS launches 90-90-90 target, which aims for 90% of people living with HIV to be diagnosed; 90% of those diagnosed to be accessing ART; and 90% of those accessing ART to achieve viral suppression by 2020.

2015

2015

In Zambia, USAID DISCOVER-Health aims to test nearly 1 million people for HIV; reach 700,000 people with prevention interventions; provide HIV treatment to 80,000 ART-naive clients, and sell 140 million socially marketed condoms.

2015

UNAIDS announces that targets for MDG 6—halting and reversing the spread of HIV — have been achieved 9 months ahead of schedule. UNAIDS releases the 2016–2021 strategy in line with the new Sustainable Development Goals, which calls for an acceleration in the global HIV response to reach critical prevention and treatment targets and achieve zero discrimination.

2015

In India, the Strategic Assessment for Strategic Action provided technical assistance to the National AIDS Control Organization to improve and use data to monitor and evaluate programs and make strategic decisions.

2016

2016

PEPFAR’s DREAMS Innovation Challenge is managed by JSI. Through DREAMS IC, 89,777 females and 10,448 males received HIV tests and results, and 21,703 vulnerable children, in particular girls, were supported with services to reduce their vulnerability to HIV.

2016

JSI leads the national Integrated HIV/AIDS Planning TA Center to support state and local HIV planning efforts across prevention, care, and treatment and meet the needs of people with and those at risk for HIV infection.

2016

JSI implements the Zambia Peer Educators for HIV Self-Testing pilot study in collaboration with Harvard University T.H. Chan School of Public Health to inform introduction and scale up of HIV self-testing targeting for female sex workers in three of Zambia’s major transportation hubs: Livingstone, Kapiri, and Chirundu.

2016

UNAIDS announces that 18.2 million people are on ART, however, increasing resistance to the drug is also noted.  Congress relaxes the ban on the use of federal funds to support syringe service programs.

2017

Zambia Supporting an AIDS-Free Era launches. It is the largest treatment service delivery program for USAID in Zambia, serving over 300,000 people. To date, the project has identified over 10,000 people living with HIV through index testing.

2017

2017

JSI launches Community HIV/AIDS Technical Assistance and Training for Planning project to build the capacity of Ryan White HIV/AIDS Program Part A planning councils and bodies across the U.S. to fulfill their legislative responsibilities, strengthen consumer engagement, and increase involvement of community providers in HIV service delivery planning.

2017

More than half of the global population living with HIV (19.5 million people) is receiving ART.  New infections have fallen by one-third in East and Southern Africa over the last six years, with particular decreases among young women and girls. It is thought that this is partly due to the DREAMS initiative.

2018

2018

JSI launches Uganda Regional Health Integration to Enhance Services-North, Lango which has supported over 84,000 people with HIV with ART and reduced mother-to-child HIV transmission rates to 2.1%.

2018

Research confirms that people with HIV who achieve and maintain an undetectable viral load cannot sexually transmit the virus to others. U=U

2018

2018

JSI is selected to assess the efficacy of the Health Resources and Services Administration HIV/AIDS Bureau AIDS Education and Training Centers Program, which aims to strengthen the HIV workforce’s capacity to improve outcomes along the HIV care continuum.

2019

JSI implements the Strengthening Systems of Care for People with HIV and Opioid Use Disorder project, which works to ensure that people with HIV and OUD have access to coordinated, client-centered, and culturally responsive care, treatment, and recovery services.

2019

The White House launches Ending the HIV Epidemic: A Plan for America. 

2019

JSI continues an initiative to deliver national virtual and classroom training to community-based organization and health department staff on CDC-supported HIV prevention public health strategies and interventions.

2020

2020

JSI launches South Africa EpiC Complementing HIV Care and Treatment Service Delivery for the City of Johannesburg to strengthen index testing and conduct targeted community case finding services.

2020

Injectable PrEP is determined to be effective in preventing HIV in men who have sex with men, and in transgender and cisgender women.

2021

Building on the National HIV/AIDS Strategy, the U.S. Department of Health and Human Services launches the HIV National Strategic Plan for the United States: A Roadmap to End the Epidemic 2021–2025.

2021

In response to COVID-19, JSI launches online HIV index testing training as part of the South Africa EpiC Complementing HIV Care and Treatment Service Delivery for the City of Johannesburg project.